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inflammation

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(in″flă-mā′shŏn ) [L. inflammare, to kindle] An immunological defense against injury, infection, or allergy, marked by increases in regional blood flow, immigration of white blood cells, and release of chemical toxins. Inflammation is one way the body uses to protect itself from invasion by foreign organisms and to repair wounds to tissue. Clinical hallmarks of inflammation are redness, heat, swelling, pain, and loss of function of a body part. Systemically, inflammation may produce fevers, joint and muscle pains, organ dysfunction, and malaise. SYN: SEE: inflammatory response SEE TABLE: Mediating Factors in Inflammation; SEE: autoimmune disease; SEE: infection

THE INFLAMMATORY PROCESSLocal inflammatory responses begin when traumatized or infected tissues activate the humoral and cellular immune systems. Complement proteins and cytokines are manufactured. These signaling proteins start a cascade of chemical events that result in increases in local blood flow and the attraction of white blood cells to the damaged tissue. White blood cells in turn consume foreign or injured cells and release arachidonic acid metabolites, kinins, histamines, and more complement, thereby amplifying and perpetuating the immune response. The white blood cells also release toxic oxygen radicals, nitric oxide, and tissue-destroying enzymes in an attempt to kill any invading microorganisms. In healthy people, the process continues until all damaged tissues or invading pathogens are removed (usually about 5 days); an inpouring of fibroblasts, which repair the injury and form a healed scar, follows.

Systemic inflammatory responses occur when foreign proteins are recognized, e.g., in the bloodstream, and immune complexes are formed or cytotoxic T cells are activated. If sepsis triggers the immune response, these agents may help clear microorganisms from the blood.

Autoimmune illnesses occur when the chemical and cellular tools of inflammation are directed against the body's own tissues.

TREATMENTMild inflammation (such as the inflammatory change from minor injuries) often resolves with the topical application of ice packs or cold water. Nonsteroidal anti-inflammatory drugs (such as ibuprofen) and steroids (such as prednisone) are useful in managing more severe inflammation, as are many disease-modifying antirheumatic drugs, such as methotrexate or azathioprine.